Article Text

PDF
Original research
Role of argatroban during neurointerventional procedures in patients with heparin induced thrombocytopenia
  1. Ali Alaraj,
  2. Matthew Tobin,
  3. Daniel Birk,
  4. Victor Aletich
  1. Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA
  1. Correspondence to Dr A Alaraj, Department of Neurosurgery (MC799), Neuropsychiatric Institute, University of Illinois at Chicago College of Medicine, 912 S Wood St, Chicago, IL 60612-7329, USA; alaraj{at}uic.edu

Abstract

Background Currently, heparin is used routinely for anticoagulation during cerebral angiography and neurointerventional procedures. In patients with heparin sensitivity, however, heparin cannot be used. Therefore, an alternative method of anticoagulation is necessary to prevent clot formation during such procedures.

Methods Argatroban, a direct thrombin inhibitor, is used as an alternate to heparin for anticoagulation. It is indicated for treatment of heparin induced thrombocytopenia as well as for prophylaxis during percutaneous coronary intervention. There are no reports describing the protocols for its use during neurointerventional procedures. We report on a series of three patients where argatroban was used in a series of three patients who underwent endovascular interventional procedures.

Results Argatroban was given in a loading dosage of 4 μg/kg/min for 10 min followed by an infusion of 1.0 μg/kg/min. During the procedure, no procedural complications were reported. Activated thrombin time was used to monitor anticoagulation.

Conclusions We describe here the use of argatroban as an alternate anticoagulant during such procedures, as well as outline our protocol for its administration.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.